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Background  Suboptimal vitamin D status is highly prevalent in Northern communities, particularly in those patients with chronic diseases such as diabetes and chronic renal disease. Emerging literature suggests that adherence to daily vitamin D supplementation may be an important factor influencing vitamin D status and overall bone health, but compliance with therapies for bone health is a major challenge. It is unknown what level of vitamin D supplementation will ameliorate or improve suboptimal vitamin D status in patients with diabetic nephropathy or contribute to improved bone health, particularly for those living in northern climates.    Methods/Design  The study purpose was to examine two different strategies of vitamin D3 supplementation; daily dosing of 2000 IU per day verses monthly dosing of 40,000 IU per month on markers of vitamin D status, bone health and to examine whether adherence, quality of life and patient satisfaction with the supplementation strategy differs between the two vitamin D strategies in adults diagnosed with diabetic nephropathy.    Discussion  The need for RCTs assessing higher doses of vitamin D 3  supplementation at varying frequencies of administration and its impact on bone health in adults with diabetes and chronic kidney disease are needed.    Trial registration  ClinicalTrials.gov  NCT01476501 .

“Vitamin D supplementation and bone health in adults with diabetic nephropathy: the protocol for a randomized controlled trial”